Associates of Kentuckiana, PSC provides care for all aspects of the prevention and
treatment of kidney disease. We work in partnership with many national
organizations which offer additional information on kidney disease and
Foundation - Any information or questions not found on our website
associated with your kidney can be found here as well as ways to
American Heart Association
- Hypertension is often associated with Chronic Kidney Disease. You
can find information about hypertension as well as preventing and
maintaining healthy heart and blood pressure at this site.
American Diabetes Association -
many individuals who deal with Chronic Kidney Disease also live with
diabetes. You may find more information on diabetes through this site.
Organ Donor Affiliates - if you or a loved one is in need of a
kidney transplant, you may find more information at this site as well
as sign up to be a donor. This will answer all of your questions
concerning donating and transplant.
Renal Patient Association - The
American Association of Kidney Patients (AAKP) is a national
non-profit organization founded by kidney patients for kidney
patients. We strive to educate and improve the health and well-being
of chronic kidney disease (CKD) patients, those on hemodialysis,
peritoneal dialysis and transplant recipients.
This is a great site that will keep you up-to-date on the news of not
only renal conditions, but other diseases and conditions you may be
10 Symptoms of Kidney Disease
Many people who have chronic kidney disease don't know it, because the
early signs can be very subtle. It can take many years to go from
chronic kidney disease (CKD) to kidney failure. Some people with CKD
live out their lives without ever reaching kidney failure.
Knowing the symptoms of kidney disease can help you get the treatment
you need to feel your best. If you or someone you know has one or more
of the following symptoms of kidney disease, or you are worried about
kidney problems, see a doctor for blood and urine tests. Remember,
many of the symptoms can be due to reasons other than kidney disease.
The only way to know the cause of your symptoms is to see your doctor.
1: Changes in Urination
Kidneys make urine, so when the kidneys are failing, the
urine may change:
You may have to get up at night
Urine may be foamy or bubbly.
You may urinate more often, or in greater amounts than usual, with
You may urinate less often, or
in smaller amounts than usual with dark colored urine.
Your urine may contain blood.
You may feel pressure or have
Symptom 2: Swelling/bone
Failing kidneys don't remove extra
fluid, which builds up in your body causing swelling in the legs,
ankles, feet, face, eyes, and/or hands. Some people with kidney
problems may have pain in the back or side related to the affected
kidney. Polycystic kidney disease, which causes large, fluid-filled
cysts on the kidneys and sometimes the liver, can cause pain and even
an increase in bone fractures.
Symptom 3: Fatigue
Healthy kidneys make a hormone called
erythropoietin (a-rith'-ro-po'-uh-tin) that tells your body to make
oxygen-carrying red blood cells. As the kidneys fail, they make less
erythropoietin. With fewer red blood cells to carry oxygen, your
muscles and brain become tired very quickly. This condition is called
anemia, and it can be treated.
Symptom 4: Skin
Kidneys remove wastes from the
bloodstream. When the kidneys fail, the buildup of wastes in your
blood can cause severe itching or bruising and pale skin.
Symptom 5: Metallic Taste
in Mouth/Ammonia Breath
A buildup of wastes in the blood (called uremia) can make food taste
different and cause bad breath. You may also notice that you stop
liking to eat meat, or that you are losing weight because you just
don't feel like eating.
Symptom 6: Nausea and Vomiting
A severe buildup of wastes in the blood
(uremia) can also cause nausea and vomiting. Loss of appetite can lead
to weight loss.
Symptom 7: Shortness of Breath
Trouble catching your breath can be
related to the kidneys in two ways. First, extra fluid in the body can
build up in the lungs. And second, anemia (a shortage of
oxygen-carrying red blood cells) can leave your body oxygen-starved
and short of breath.
Symptom 8: Feeling Cold
Anemia can make you feel cold all the
time, even in a warm room.
Symptom 9: Dizziness and Trouble Concentrating
Anemia related to kidney failure means
that your brain is not getting enough oxygen. This can lead to memory
problems, trouble with concentration, and dizziness.
Symptom 10: Other symptoms
High blood pressure
Chest pain due to pericarditis
(inflammation around the heart)
Bleeding (due to poor blood
Decreased sexual interest and
Altered mental status
(encephalopathy from the accumulation of waste products or uremic
Restless legs syndrome
FREQUENTLY ASKED QUESTIONS:
Q: How can I find out if I am in
the early stages of CKD?
A: More than 26 million Americans have chronic kidney
disease (CKD) and most don’t know it. The
Foundation’s Kidney Early Evaluation
Program (KEEP®) offers free screenings for those at risk–anyone 18 years
and older with high blood pressure, diabetes or a family history of these
conditions or kidney disease. The KEEP program is finding kidney disease
at the earliest stage possible.
KEEP provides three simple tests that determine kidney function.
Participants receive a comprehensive health risk appraisal, blood pressure
measurement, blood and urine testing and the opportunity to discuss their
health and review results with onsite clinicians. Learn more and
find a free screening near you.
anything be done to prevent recurring Urinary Tract Infections (UTI)?
A. You can help lessen the chance of recurring UTIs by recognizing
signs and symptoms of a UTI and taking appropriate action to see your
doctor early. You should follow your doctor's advice and take all
prescribed antibiotics as ordered and drink plenty of fluids. You
should empty your bladder frequently, especially at night before going
to bed. New studies show that drinking cranberry juice daily or eating
cranberry products may help. Cranberries contain certain compounds
that may stop bacteria from attaching to the urinary tract wall.
Q: How common is Chronic Kidney Disease (CKC)?
A: Some 26 million Americans (13 percent of the U.S. adult population)
suffer from CKD—a figure experts predict will rise due to high obesity
rates (1/3 of all adults), the link between obesity, diabetes and high
blood pressure (all risk factors) and the aging of the Baby Boom
generation (since age is another risk factor for CKD). Young and
middle-aged adults can also develop CKD. [TOP]
Q: Can CKD be prevented?
A: Taking care of overall health helps protect kidney health. Wise
practices include exercising regularly, low salt diet, controlling
weight, monitoring blood pressure, cholesterol and glucose levels, not
smoking, drinking moderately, avoiding non-steroidal anti-inflammatory
drugs (NSAIDs) and getting an annual physical. [TOP]
Q: What questions should I ask my doctor?
A: No two people are alike, so asking questions
is the best way to find out about your health. On this Life Options
website, you can download a Patient Interest Checklist that will help
you figure out questions. You'll also find a few basic ideas below,
and you can add your own. If you write your questions and show the
list to your doctor, you may be more likely to get them answered.
Write down the answers, too—or have a family member come along to help
you remember the answers.
1. What percent of kidney function do I have now?
2. What is the cause of my kidney problem?
3. What are my lab test results right now?
4. What can I do to keep my kidneys working as long as possible?
5. What treatment is available for my symptoms? (List symptoms)
6. What are the next steps for my treatment?
7. Will I eventually need dialysis or a transplant, if so, how long
might it be until I do? [TOP]
Why Are the Kidneys So
Most people know that a major function of the kidneys is to remove
waste products and excess fluid from the body. These waste products
and excess fluid are removed through the urine. The production of
urine involves highly complex steps of excretion and reabsorption.
This process is necessary to maintain a stable balance of body
The critical regulation of the body's salt, potassium and acid content
is performed by the kidneys. The kidneys also produce hormones that
affect the function of other organs. For example, a hormone produced
by the kidneys stimulates red blood cell production. Other hormones
produced by the kidneys help regulate blood pressure and control
The kidneys are powerful chemical factories that perform the following
* remove waste products from the body
* remove drugs form the body
* balance the body's fluids
* release hormones that regulate blood pressure
* produce an active form of vitamin D that promotes strong, healthy
* control the production of red blood cells [TOP]
the Kidneys and How Do They Function?
There are two kidneys, each about the size of a fist, located on
either side of the spine at the lowest level of the rib cage. Each
kidney contains up to a million functioning units called nephrons. A
nephron consists of a filtering unit of tiny blood vessels called a
glomerulus attached to a tubule. When blood enters the glomerulus, it
is filtered and the remaining fluid then passes along the tubule. In
the tubule, chemicals and water are either added to or removed from
this filtered fluid according to the body's needs, the final product
being the urine we excrete.
The kidneys perform their life-sustaining job of filtering and
returning to the bloodstream about 200 quarts of fluid every 24 hours.
About two quarts are removed from the body in the form of urine, and
about 198 quarts are recovered. The urine we excrete has been stored
in the bladder for anywhere from 1 to 8 hours. [TOP]
What Are Some of the Causes of Chronic Kidney Disease?
Chronic kidney disease is defined as having some type of kidney
abnormality or "marker" such as protein in the urine, and having
decreased kidney function for three months or longer.
There are many causes of chronic kidney disease. The kidneys may be
affected by diseases such as diabetes and high blood pressure. Some
kidney conditions are inherited (run in families).
Others are congenital; that is, individuals may be born with an
abnormality that can affect their kidneys. The following are some of
the most common types and causes of kidney damage.
Diabetes is a disease in which your body does not make enough insulin
or cannot use normal amounts of insulin properly. This results in a
high blood sugar level, which can cause problems in many parts of your
body. Diabetes is the leading cause of kidney disease.
High blood pressure (also known as hypertension) is another common
cause of kidney disease and other complications such as heart attacks
and strokes. High blood pressure occurs when the force of blood
against your artery walls increases. When high blood pressure is
controlled, the risk of complications such as chronic kidney disease
is decreased. (For more information about high blood pressure,
Glomerulonephritis is a disease that causes inflammation of the
kidney's tiny filtering units called the glomeruli. Glomerulonephritis
may happen suddenly, for example, after a strep throat, and the
individual may get well again.However, the disease may develop slowly
over several years and it may cause progressive loss of kidney
function. (For more information on Glomerulonephritis,
Polycystic kidney disease is the most common inherited kidney disease.
It is characterized by the formation of kidney cysts that enlarge over
time and may cause serious kidney damage and even kidney failure.
Other inherited diseases that affect the kidneys include Alport's
Syndrome,primary hyperoxaluria and cystinuria. (For more information
on Polycystic Kidney Disease,
Kidney stones are very common, and when they pass, they may cause
severe pain in your back and side. There are many possible causes of
kidney stones, including an inherited disorder that causes too much
calcium to be absorbed from foods and urinary tract infections or
obstructions. Sometimes, medications and diet can help to prevent
recurrent stone formation. In cases where stones are too large to
pass, treatments may be done to remove the stones or break them down
into small pieces that can pass out of the body. (For more information
on About Kidney Stones, and Diet and Kidney Stones,
Urinary tract infections occur when germs enter the urinary tract and
cause symptoms such as pain and/or burning during urination and more
frequent need to urinate. These infections most often affect the
bladder, but they sometimes spread to the kidneys, and they may cause
fever and pain in your back. (For more information about Urinary Tract
Congenital diseases may also affect the kidneys. These usually involve
some problem that occurs in the urinary tract when a baby is
developing in its mother's womb. One of the most common occurs when a
valve-like mechanism between the bladder and ureter (urine tube) fails
to work properly and allows urine to back up (reflux) to the kidneys,
causing infections and possible kidney damage.
Drugs and toxins can also cause kidney problems. Using large numbers
of over-the-counter pain relievers for a long time may be harmful to
the kidneys. Certain other medications, toxins, pesticides and
"street" drugs such as heroin and crack can also cause kidney damage.
How is Chronic
Kidney Disease Detected?
Early detection and treatment of chronic kidney disease are the
keys to keeping kidney disease from progressing to kidney failure.
Some simple tests can be done to detect early kidney disease. They
1. Blood pressure measurement
2. A test for protein in the urine. An excess amount of protein in
your urine may mean your kidney's filtering units have been damaged by
disease. One positive result could be due to fever or heavy exercise,
so your doctor will want to confirm your test over several weeks.
3. A test for blood creatinine. Your doctor should use your results,
along with your age, race, gender and other factors, to calculate your
glomerular filtration rate (GFR). Your GFR tells how much kidney
function you have.
Access the GFR calculator.
It is especially important that people who have an increased risk for
chronic kidney disease have these tests. You may have an increased
risk for kidney disease if you:
* are older
* have diabetes
* have high blood pressure
* have a family member who has chronic kidney disease
* are an African American, Hispanic American, Asians and Pacific
Islander or American Indian.
If you are in one of these groups or think you may have an increased
risk for kidney disease, ask your doctor about getting tested.
Disease Be Successfully Treated?
Many kidney diseases can be treated successfully. Careful control of
diseases like diabetes and high blood pressure can help prevent kidney
disease or keep it from getting worse. Kidney stones and urinary tract
infections can usually be treated successfully. Unfortunately, the
exact causes of some kidney diseases are still unknown, and specific
treatments are not yet available for them. Sometimes, chronic kidney
disease may progress to kidney failure, requiring dialysis or kidney
transplantation. Treating high blood pressure with special medications
called angiotensin converting enzyme (ACE) inhibitors often helps to
slow the progression of chronic kidney disease. A great deal of
research is being done to find more effective treatment for all
conditions that can cause chronic kidney disease. [TOP]
How is Kidney Failure
Kidney failure may be treated with
hemodialysis, peritoneal dialysis or kidney transplantation.
Treatment with hemodialysis (the artificial kidney) may be performed
at a dialysis unit or at home. Hemodialysis treatments are usually
performed three times a week.
Peritoneal dialysis is generally done daily at home. Continuous
Cycling Peritoneal Dialysis requires the use of a machine while
Continuous Ambulatory Peritoneal Dialysis does not. A kidney
specialist can explain the different approaches and help individual
patients make the best treatment choices for themselves and their
Kidney transplants have high success rates. The kidney may come
from someone who died or from a living donor who may be a relative,
friend or possibly a stranger, who donates a kidney to anyone in need
of a transplant. Learn more about organ donating at
Kentuckiana Organ Donors. [TOP]
What Are the
Warning Signs of Kidney Disease?
Kidney disease usually affects both kidneys. If the kidneys' ability
to filter the blood is seriously damaged by disease, wastes and excess
fluid may build up in the body. Although many forms of kidney disease
do not produce symptoms until late in the course of the disease, there
are six warning signs of kidney disease:
1. High blood pressure.
2. Blood and/or protein in the urine.
3. A creatinine and Blood Urea Nitrogen (BUN) blood test, outside the
normal range. BUN and creatinine are waste that build up in your blood
when your kidney function is reduced.
4. A glomerular filtration rate (GFR) less than 60. GFR is a measure
of kidney function.
5. More frequent urination, particularly at night; difficult or
6. Puffiness around eyes, swelling of hands and feet. [TOP]
How Well Do Your Kidneys
By Gerard J. Stanley, Sr., MD (from the National Kidney
The kidneys perform several important jobs including the removal of
chemical and mineral impurities from the blood, balancing acid in the
blood, and controlling body fluids. These delicate processes take
place when blood flows through the kidneys. The kidneys also help to
control your body’s production of red blood cells, regulate blood
pressure, and help keep bones strong and healthy. Each kidney has
about a million tiny nephrons. Each nephron has a group of tiny blood
vessels called a glomerulus. The glomerulus is the small structure in
charge of filtering and cleaning the blood as it flows through the
kidney. The rate at which the glomerulus filters the blood is called
the glomerular filtration rate or “GFR”.
The kidneys filter almost 200 quarts of blood every day and make
approximately two quarts of urine as the waste product. When the
kidneys don't work like they should, products in the blood which are
supposed to be removed, like the blood urea nitrogen (BUN), and
creatinine (Cr) stay in the blood and can be easily measured with a
blood test. Other products that are supposed to stay in the blood,
like proteins, end up in the urine and can be measured with a urine
The National Kidney Foundation (NKF) wants doctors to calculate, and
patients to know, their GFR number. If your doctor has drawn blood to
check your creatinine, he or she can very easily figure out your GFR.
By calculating your GFR and checking urine protein, your doctor can
tell if you may be in the early stages of chronic kidney disease, or
CKD. If steps are not taken to slow the worsening of kidney function,
the kidneys may eventually fail and either dialysis or kidney
transplant would be needed to live.
The most frequent causes of kidney disease are poorly controlled
diabetes and high blood pressure. Other common kidney diseases are
glomerulonephritis, which causes inflammation and damage to the
glomerulus, and polycystic kidney disease—an inherited disease that
causes large cysts to form in the kidney. Another common but often
overlooked cause of kidney disease, is the overuse of analgesics, or
pain-relieving medicines, especially aspirin, acetaminophen (Tylenol),
and non-steroidal drugs (NSAIDs) like ibuprofen, ketoprofen, and
naproxen (Aleve). Because these drugs can be bought over the counter
they can be quite easily taken in large amounts. These medicines can
be toxic to the kidneys, causing permanent damage.
There are usually no symptoms in the early stages of kidney disease,
but as it gets worse, you may have high BUN and creatinine on lab
tests, nausea and vomiting, less appetite, weakness, extreme
tiredness, itching, muscle cramps and anemia.
Warning signs of kidney disease:
1) high blood pressure
2) blood and/or protein in the urine
3) decreasing GFR
4) more frequent urination; pain or difficulty urinating
5) puffiness around eyes; swelling of hands, feet
You can do some things to reduce the risk of getting kidney disease or
slow it from getting worse. Work with your doctor to start an “ACE
Inhibitor” blood pressure medicine. ACEs have been found to help
protect kidney function as well as lower blood pressure. People with
diabetes should take an ACE to protect their kidneys even if they do
not have high blood pressure. Keeping good control of blood sugar is
important. If protein is found in the urine, working with a dietitian
to control diabetes and eating a lower protein diet may be needed.
Staying physically fit is important for kidney function. Exercise
helps kidney disease by improving muscle function, lowering blood
pressure, lowering cholesterol, keeping a healthy body weight and
improving your sleep. Start an exercise program with an activity that
you like, such as walking, swimming, bicycling or dancing. “Start low
and go slow” but try to exercise at least 30 minutes, three times a
week. You should be able to talk to your exercise partner while
working out, and you should feel completely recovered within one hour
of your routine.
Pain-relieving medicine should be taken carefully and only when
needed. Speak to your doctor if you need to take pain medicines for
more than 10 days in a row because of a chronic pain problem such as
arthritis. Avoid combination drugs that have acetaminophen, NSAIDs,
and caffeine. Always drink six to eight glasses of water each day if
you are taking these medicines.
Pay attention to the warning signs of kidney disease: 1) high blood
pressure; 2) blood and/or protein in the urine; 3) decreasing GFR; 4)
more frequent urination; pain or difficulty urinating 5) puffiness
around the eyes; swelling of hands and feet.
Calculating your GFR is very easy and your doctor should do it at
least once a year if you are at risk for getting kidney disease, and
more often if you have kidney disease. For doctors and patients who
are not familiar with how to calculate GFR, the National Kidney
Foundation Web site has an
online GFR calculator. [TOP]